MID-DEL VISION SOURCE, PLLC
NPI: 1982940508
· MIDWEST CITY, OK 73130
· 332H00000X
$388K
Total Medicaid Paid
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
960 |
$34K |
| 2022 |
4,402 |
$153K |
| 2023 |
3,857 |
$138K |
| 2024 |
1,596 |
$62K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
1,551 |
1,551 |
$161K |
| 92004 |
|
731 |
731 |
$92K |
| 92340 |
|
1,587 |
1,577 |
$48K |
| 92015 |
|
2,665 |
2,664 |
$47K |
| V2103 |
Spherocylindr 4.00d/12-2.00d |
950 |
943 |
$23K |
| V2020 |
Vision svcs frames purchases |
1,703 |
1,694 |
$17K |
| V2100 |
Lens spher single plano 4.00 |
25 |
25 |
$558.00 |
| V2784 |
Lens polycarb or equal |
1,603 |
1,593 |
$0.00 |